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See a sample rate comparisonCPT 44403 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Colonoscopy W/Resection, Removal Of Lining Of Large Bowel Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | 59 - Distinct Procedural Service PT - Colorectal cancer screening test; converted to diagnostic test or other procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $265.87 national non-facility rate (2026) · View Medicare rates for 44403 |
| Medicaid Fee Schedule | $216.505 median of the 8 states in the free preview · View Medicaid rates for 44403 |
National average reimbursement for CPT 44403 by major payers:
$421.33
$426.03
$422.35
$522.29
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CPT 44403
5 of 25 sample ratesHigher to lower in this preview
St Vincent Hospital-Hospital Sisters-Third Order Of St Francis, Prevea Surgery Center
St Vincent Hospital-Hospital Sisters-Third Order Of St Francis
$3,481.00Published rateUh North Ridgeville Endoscopy Center LLC
$1,386.00Published rateOptum Care Washington PLLC, The Edmonds Surgery Center
The Everett Clinic, PLLC
$915.00Published rateInnovative Surgery Center, LLC
Innovative Surgery Center LLC
$553.00Published rateChesapeake Ambulatory Surgery Center
$319.00Published rate
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See a sample payer proposalCPT 44403 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44403 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 44403 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 44401-CPT | High | Colonoscopy With Ablation, Destruction Of Tissue Abnormalities Tumors Or Polyps Of Large Bowel Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy) |
| 44402-CPT | Moderate | Colonoscopy Through Stoma; Diagnostic, Including Collection Of Specimenss By Brushing Or Washing When Performed, With Endoscopic Stent Placement Including Pre And Post-Dil |
| 44403-CPT | Moderate | Colonoscopy W/Resection, Removal Of Lining Of Large Bowel Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy) |
| 44404-CPT | Moderate | Colonoscopy W/Injection, Injections Beneath Lining Of Large Bowel Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44403. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44403 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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